{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T15:28:53Z","timestamp":1780673333190,"version":"3.54.1"},"reference-count":42,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T00:00:00Z","timestamp":1730764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Objectives: Primary hyperparathyroidism (PHPT) is associated with normal or elevated calcium levels and affects bone mineral density. The proportion of cases predisposed to metabolic bone disease is unknown in patients with PHPT. The aim of this study was to assess bone mineral density and bone quality in patients with normo- or hypercalcemic primary hyperparathyroidism undergoing baseline parathyroid gland assessment with [18F]fluorocholine PET\/CT imaging. Methods: A total of 140 consecutive patients were enrolled in this observational study. All patients with normo- or hypercalcemic primary hyperparathyroidism underwent dual-energy X-ray absorptiometry (DXA) for assessment of bone mineral density (BMD) and trabecular bone score (TBS). [18F]fluorocholine PET\/CT was performed in all patients for the detection and localization of parathyroid adenoma. Hyper- and normocalcemic patients were compared with regard to the proportion of osteoporosis and osteopenia, T-Score, TBS, serum calcium, phosphorus and parathyroid hormone levels, the maximum standardized uptake value (SUVmax) in PET\/CT imaging, and laboratory results. Results: The majority of patients was female (88.57%) and had a pathologic bone mineral density (52.86%). Overall, 33 patients had osteoporosis and 41 osteopenia. The mean lumbar T-Score was \u22121.48 (SD 1.37) and the T-Score of the femoral neck was \u22121.21 (SD 0.92). Mean TBS was also decreased (\u22122.13). No difference was found between normo- or hypercalcemic patients regarding bone metabolism and imaging parameters. Conclusions: More than half of patients with normo- or hypercalcemic PHPT showed abnormal BMD. First-line [18F]fluorocholine PET\/CT identified parathyroid adenoma in a high proportion of patients, even in patients with normocalcemic PHPT. The early evaluation of metabolic bone disease seems desirable in clinical management of females with PHPT.<\/jats:p>","DOI":"10.3390\/diagnostics14222466","type":"journal-article","created":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T05:30:53Z","timestamp":1730784653000},"page":"2466","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Bone Mineral Density and First Line Imaging with [18F]fluorocholine PET\/CT in Normocalcemic and Hypercalcemic Primary Hyperparathyroidism: Results from a Single Center"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9311-7413","authenticated-orcid":false,"given":"Dagmar","family":"Schaffler-Schaden","sequence":"first","affiliation":[{"name":"Institute of General Practice, Family Medicine and Preventive Medicine, Center for Public Health and Healthcare Research, Paracelsus Medical University, Strubergasse 21, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregor","family":"Schweighofer-Zwink","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Endocrinology, University Hospital Salzburg, Muellner Hauptstrasse 48, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9920-7359","authenticated-orcid":false,"given":"Lukas","family":"Hehenwarter","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Endocrinology, University Hospital Salzburg, Muellner Hauptstrasse 48, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7167-7524","authenticated-orcid":false,"given":"Antje","family":"van der Zee-Neuen","sequence":"additional","affiliation":[{"name":"Center for Physiology, Pathophysiology and Biophysics, Institute for Physiology and Pathophysiology, Paracelsus Medical University, Strubergasse 21, 5020 Salzburg, Austria"},{"name":"Gastein Research Institute, Paracelsus Medical University, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Flamm","sequence":"additional","affiliation":[{"name":"Institute of General Practice, Family Medicine and Preventive Medicine, Center for Public Health and Healthcare Research, Paracelsus Medical University, Strubergasse 21, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3918-3812","authenticated-orcid":false,"given":"Mohsen","family":"Beheshti","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Endocrinology, University Hospital Salzburg, Muellner Hauptstrasse 48, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4502-0609","authenticated-orcid":false,"given":"Christian","family":"Pirich","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Endocrinology, University Hospital Salzburg, Muellner Hauptstrasse 48, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3993","DOI":"10.1210\/jc.2018-01225","article-title":"Primary Hyperparathyroidism","volume":"103","author":"Bilezikian","year":"2018","journal-title":"J. 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